Letter from JCVI on considerations on COVID-19 vaccination of adult household contacts of severely immunosuppressed adults: 24 March 2021
Published 29 March 2021
Applies to England
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From:
JCVI Secretariat
133 to 155 Waterloo Road
London
SE1 8UG
To:
Rt Hon Matt Hancock MP, Secretary of State for Health and Social Care
24 March 2021
Dear Secretary of State,
Adults with immunosuppression are more likely to have poor outcomes following infection with SARS-CoV2 and may respond less well to vaccines offered. JCVI have been regularly monitoring data from the rollout of the COVID-19 vaccination programme in the UK.
Early data indicate lower protection in vaccinated adults who are immunosuppressed. Those with severe immunosuppression are therefore more likely to suffer poor outcomes following infection and are less likely to benefit from the vaccines offered.
Data from SIREN and other academic studies indicate that vaccination of non-immunosuppressed persons with the AstraZeneca or Pfizer-BioNTech vaccine can reduce the risk of asymptomatic infection. It can be inferred that a reduction in asymptomatic infection would also mean a reduction in the chance of transmission of SARS-CoV-2. A very recent study from Scotland of household contacts of healthcare workers further supports the premise of a reduction in transmission of SARS-CoV2 following vaccination.
As we now have data indicating the potential for a reduction in transmission in those vaccinated, we advise that adult household contacts of adults with severe immunosuppression,[footnote 1] aged 16 and over, are offered COVID-19 vaccination alongside priority group 6. This will help reduce the risk of infection in those who may not be able to fully benefit from being vaccinated themselves.
A reasonable definition of household contacts would be individuals who expect to share living accommodation on most days and therefore for whom continuing close contact is unavoidable. This follows wording in the Green Book: Immunisation against infectious disease Influenza chapter. We understand that NHS England and NHS Improvement will publish operational guidance to accompany this advice.
There are still no data on the safety, reactogenicity or efficacy of COVID-19 vaccines in children, although these will begin to become available over the coming months as industry led studies in children begin. Children are also much less likely to have poor outcomes from COVID-19, and almost all deaths in children have been in those with severe neuro-disabilities, who will be offered vaccination in priority group 6. Given this we do not currently advise vaccination of household contacts of immunosuppressed children, or household contacts of immunosuppressed adults who are themselves children. This will be kept under review by JCVI as more evidence becomes available.
Yours sincerely
Professor Wei Shen Lim
Chair (COVID-19) of the Joint Committee on Vaccination and Immunisation
Cc: Jonathan Van-Tam (DCMO) and Dr Mary Ramsay (Head of Immunisation – PHE)